After successive cancer therapies, multiple subpopulations of cancer cells arise, each with divergent genetic aberrations that may confer drug resistance or susceptibility. Tissue biopsies may not detect these subpopulations, but a liquid biopsy of blood using Epic Sciences’ “no cell left behind” technology may help identify these important tumor cells and characterize how a patient’s tumors have evolved over time.

In a study that will be reported this week at the EORTC International Conference on Molecular Targets and Cancer Therapeutics in Boston, a patient who had multiple rounds of chemotherapy to treat advanced metastatic colorectal cancer had a few milliliters of his blood analyzed on Epic Sciences’ liquid biopsy platform. The technology identified and isolated 34 circulating tumor cells (CTCs) through a proprietary combination of protein expression and morphology, and then performed single cell sequencing on every CTC identified to assess 500 cancer genes.

Epic Sciences’ data revealed that 70% of the CTCs had an early MLL3 driver mutation, while several CTC subpopulations had genetic aberrations indicative of drug resistance, including in APC (12%), BRCA1/2 (8%), KRAS (6%), PI3KCA (6%) and TP53 (6%) genes. Researchers also interrogated CTCs that would not be detected in other liquid biopsies, which only assess CTCs that express EpCAM or that are sufficiently large in size. Several of these CTCs harbored driver mutations that, if known, could influence therapeutic decision-making.

“These data show that our liquid biopsy platform is capable of isolating and examining individual CTCs for genomic instability, in addition to morphology and protein marker expression associated with cancer,” said Murali Prahalad, Ph.D., CEO of Epic Sciences. “Our comprehensive analysis is a departure from current tests that treat cancer as a disease of averages or ignore whole classes of tumor cells. This approach teases apart the clonality of a patient’s cancer and has the potential to customize and rationally assign combination therapies that can target the disease from many different angles.”

About Epic Sciences

At Epic Sciences, we develop clinically proven predictive tests to detect and monitor cancer at the individual cell level. With a proprietary rare-cell detection engine, we provide insights to clinical, biotech, pharmaceutical and academic teams on how cancer emerges, mutates and remits so they can make pivotal decisions at every point in patient treatment with greater certainty. Recognizing the unique nature of each person’s cancer, we offer truly personalized diagnostic tests, while being non-invasive for the patient.

We have developed the first clinically proven predictive test for metastatic castration-resistant prostrate cancer (mCRPC), the Epic AR-V7 test. Using the same rare-cell detection platform and Epic’s biobank of over 30,000 blood samples, each profiled with predictive biomarkers, we partner with leading pharmaceutical and biotechnology companies, major cancer centers, the National Cancer Institute (NCI), and the National Institutes of Health (NIH) to pursue additional predictive tests for breast, ovarian, colon and other cancers and diseases. Our mission is to revolutionize cancer care and therapies to make them as precise, safe and life-sustaining as humanly possible.